Dr. Pathik Parikh Hepatologist and Liver Transplant Physician

Successful Management of Anti Tuberculosis Therapy induced liver failure by Liver Team 50 year old female during routine follow up was diagnosed to have mild pericardial effusion. She was started empirically on 4 drugs anti tuberculosis therapy (ATT). She tolerated the therapy well and on completion of intensive phase her pericardial effusion disappeared. She was maintained on isoniazid, rifampicin and ethambutol therapy. 4 months after starting ATT, she noticed jaundice and consulted her physician who stopped ATT and started her on Ursodeoxycholic acid. However, her jaundice worsened and that is when she presented to Zydus Hospitals. At the first visit she had full blown liver failure. Her reports showed a bilirubin of 14 mg/dl, AST 157 IU/ml, ALT 90 IU/ml, Albumin 2.9 mg/dl and a International Normalized Ratio (PT-INR) of 7.1. Her ultrasound showed mild ascites and hypo echoic liver. She had over encephalopathy with flaps on examination. She was counseled about the need for l

All patients who are  suffering from liver disease  and need a transplant are currently in dilemma on when and how the transplant would proceed. Even doctors are in dilemma on whether they should divert the healthcare staff and infrastructure to transplant when we have a great pandemic going on. To answer these queries, the American, European, Asian and Indian societies have drawn out guidelines for doctors to help in decision making. Should we as healthcare providers decide on who is more in need of limited resources, i.e., COVID-19 patients versus patients in  urgent need of liver transplantation?  It is impossible to weigh the value of the life of a patient with COVID-19 against that of a patient in need of life-saving liver transplantation. We should not compound the pandemic by risking the lives of patients in need of liver transplantation and our goal should be to ensure that an ICU bed is available for every patient who requires one. All centers offering transplant would

What do you mean by cirrhosis of liver? In medical terms cirrhosis is diffuse irreversible damage to liver parenchyma. In the current era, it is irreversible. That means that the damage to the liver has crossed the point of no return. Although, you can remain stable with cirrhosis, you cannot cure or reverse cirrhosis of liver.  Under normal circumstances, liver is smooth and soft to touch. In cirrhosis your liver becomes hard and irregular and rough. In simple terms, it means, your liver is damaged. How does cirrhosis affect your body? Liver performs more than 500 functions. So when you develop cirrhosis, these functions start decreasing. Some of these functions include cleaning of toxic byproducts of your body, metabolizing all the food that you eat, storing important vitamins and even forming proteins necessary for life. Besides, all the blood from your tummy (including from your intestines), drain through the liver into the heart. In cirrhosis this drainage i